title: Body mass index in chronic heart failure: association with biomarkers of neurohormonal activation, inflammation and endothelial dysfunction.
abstract: BACKGROUND
  Low body mass index (BMI) is associated with a poor outcome in chronic heart failure (CHF). An inverse association between BMI and adiponectin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been reported. The aim of the present study was to investigate whether novel markers of neurohormonal activation, inflammation, and endothelial dysfunction are associated with BMI in CHF.
  
  
  METHODS
  In a cross-sectional study including 171 patients with CHF and a left ventricular ejection fraction (LVEF) ≤45% the impact of BMI on circulating plasma concentrations of adiponectin, α-defensins, high sensitivity C-reactive protein (hsCRP), copeptin, mid-regional pro-adrenomedullin (MR-proADM), NT-proBNP, and mid-regional pro-A-type natriuretic peptide (MR-proANP) were evaluated.
  
  
  RESULTS
  In multivariable linear regression analysis including age, sex, LVEF, New York Heart Association functional classification (NYHA), estimated glomerular filtration rate (eGFR), and diabetes, only NT-proBNP (β = -0.32) and adiponectin (β = -0.39) remained independently associated with BMI. MR-proANP was associated with BMI but adjusting for age attenuated the relation being no longer significant.
  
  
  CONCLUSIONS
  Among biomarkers typically increased in patients with CHF only adiponectin and NT-proBNP demonstrated independent inverse associations with BMI. This indicates a direct effect of these two biomarkers enhancing the wasting process seen in CHF.
authors.affiliation: Departments of Cardiology and Endocrinology, Herlev University Hospital, Ringvej 75, Herlev 2730, Denmark. heidichristensen@dadlnet.dk.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Christensen
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
authors.forename: Jens P
authors.initials: JP
authors.lastname: Goetze
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.forename: Caroline
authors.initials: C
authors.lastname: Kistorp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood; D036361:Peptide Hormones / Q000097:blood*; D013318:Stroke Volume / Q000502:physiology
chemical_list: D015415:Biomarkers; D018377:Neurotransmitter Agents; D036361:Peptide Hormones; D002097:C-Reactive Protein